This is a 66 y/o man who experiences unusual episodes of weakness of the right leg – particularly when climbing hills. It will become so weak that he will collapse. Sometimes the weakness is accompanied by burning pain. The examination is normal. A MRI of the lumbosacral spine was normal. I performed an EMG study which showed clear signs of a right L5 radiculopathy. I reviewed the prior MRI scan of the lumbar spine and in reality there were signs for a possible dural AV fistula. I sent him for an iodine angiogram study. The angiogram shows a dural arterio-vascular malformation (AVM) supplied by an artery at the L3 level. DIAGNOSIS: Spinal Dural AVM

MRI: T2 signal in cord with a large vessel flow channel concerning for dural AVF.